• The state must adopt a “Money Follows the Person” system in which consumers have options and can choose to receive care in nursing homes, assisted living facilities, or their own homes.

 

• Every long term care service should be a high quality service and Medicaid dollars should never support substandard care.

3. Campaign members deliver testimony in state appropriations hearing subcommittees          

Campaign members testified at both the House and Senate Appropriations subcommittee meetings on the Medicaid budget urging the legislature to expand the cost-effective MiChoice program.  To read testimony submitted by statewide chairperson Bill Mania and counsel Alison Hirschel, go to http://campaignforqualitycare.org/Legislation/Legislation.htm. Another Campaign family, Steve, Lori, and Jacob West, also provided testimony about their experiences trying to obtain care for Jacob, a young adult with severe disabilities, and the importance of the MiChoice Home and Community Based Waiver. A number of other consumers and advocates from other groups also spoke about MiChoice. The Senate Appropriations Subcommittee will hold another hearing on May 3 from 2-5 on the first floor of the Boji Tower at the corner of Allegan and Capitol in Lansing. 

      Please come on May 3^rd and share your story to demonstrate the importance of preserving Medicaid funded long term care! If you cannot attend, take advantage of AARP’s toll-free Medicaid Preservation Hotline at 1-888-232-6829, which will automatically direct your call to your representatives.

4. State budget woes continue to threaten long term care supports and services

The state continues to face a real budget crisis and, unless and until legislators and the Governor agree on a plan to raise revenues and replace the Single Business Tax, Medicaid funded long term care supports and services remain very vulnerable to cuts. This week, the state Department of Community Health notified nursing homes that they would be required to pay provider taxes earlier than in the past to address the state’s cash flow crisis. Without additional revenues, more drastic measures are likely including possible reductions or delays in provider payments, tightened eligibility requirements for Medicaid funded programs, reductions in services, and other changes. In addition, other state services that protect vulnerable consumers are likely to be affected as well. Budget cutbacks and hiring freezes in recent years have already had a dramatic impact on the Bureau of Health Systems which needs many more nursing home inspectors; the Office of Long Term Care Supports and Services which is not fully staffed; the Department of Human Services which has inadequate staff to assure applications for Medicaid and other benefits are processed promptly; Adult Protective Services in which staff has declined alarmingly and precipitously; and other state programs and offices. Additional cutbacks will spell more pain and risk for consumers. For detailed information on the state’s budget crisis, visit the Michigan League for Human Services website at http://www.milhs.org/. In addition, a very helpful and accessible brochure is available athttp://www.milhs.org/Media/EDocs/brochurecombinedred.pdf.

5. Campaign members participate in a panel discussion on long term care at Western Michigan University

Campaign members John Weir and Paul VanWestrienen participated in a panel discussion on long term care at Western Michigan University on April 11. The event, which was organized by gerontologist and Campaign friend Dr. Maureen Mickus, attracted more than 100 participants. The event included a viewing of “Almost Home,” a public television documentary about one nursing home that embarked on the process of “culture change” to create a more home like environment in which residents and staff worked together to ensure residents have more choice and control over their lives and environment. For more information on culture change, visit NCCNHR’s website at: http://www.nccnhr.org/uploads/CultureChange06.pdf 

 

6. U.S. General Accountability Office issues new report highlighting failures of the federal nursing home enforcement system to stop some homes from repeatedly harming residents

In a report released in March, 2007, the General Accountability Office took another look at federal enforcement efforts in nursing homes. The report examines 63 homes in four states, including Michigan, with a history of harming residents. It concludes that although the number of serious citations declined between 2000 and 2005 (in Michigan, 42.8 percent of homes were cited for serious violations in 2000 while only 22.9 percent were cited for that level of deficiency in 2005), this data may be due to weaknesses in the inspection process and underreporting of serious issues. Despite efforts to improve the federal enforcement process, almost half the 63 homes continued to cycle in and out of compliance with federal standards. According to the GAO, the federal government’s enforcement system is too complex and has only fragmented and incomplete data. The GAO recommends that the government:

•  Improve its “immediate sanctions” policy to ensure that homes that repeatedly harm residents do not escape immediate penalties;

 

•  Strengthen the deterrent effect of certain sanctions;

 

• Expand additional enforcement efforts for homes with a history of noncompliance; and

 

• Improve the effectiveness of its data systems. 

Mike Dankert, Bureau Chief of Michigan’s Bureau of Health Systems, provided a response to the GAO report concurring with many of the concerns expressed and explaining how Michigan is attempting to craft more effective sanctions. The Campaign will seek to work with Mike to address the issues raised in the report. The full report is available at: http://www.gao.gov/new.items/d07241.pdf.

7. State invites consumers and other stakeholders to participate in a discussion about the future of the MiChoice Waiver

The MiChoice Home and Community Based Waiver program can exist only if the federal government approves the State’s waiver plan. That approval must be renewed periodically. Since Michigan must submit a waiver renewal request this summer, the State has convened a workgroup of stakeholders, including consumers and their advocates, to advise the Department of Community Health how we might want to change MiChoice. One issue that has generated considerable debate is whether MiChoice should be available to consumers in homes for the aged (hfa) and adult foster care (afc) homes. While most consumers appear to agree that consumers who are eligible for MiChoice should be able to obtain the services in the setting of their choice, others worry that afc and hfa homes are too institutional, that allowing MiChoice to be used in these settings will diminish the availability of waiver services for individuals who are trying to return to or remain in the community in more independent settings, and that afc and hfa providers will look to MiChoice to provide services and supports the facility would otherwise provide itself. The Governor’s Medicaid Long Term Care Task Force recommended expanding the waiver to hfa and afc settings in 2005 and many consumers hope this issue will finally be resolved when the state submits its new application for approval of the MiChoice waiver.

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The Campaign offers heartfelt thanks to AARP/Michigan for its generous support. AARP’s assistance has enabled us to reproduce and send this copy of our newsletter and print numerous copies of our organization’s brochure to share with legislators and consumers. Thanks for standing by our side, AARP!!